Teen Buried after Failed Breast Surgery - Inverted Areola

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Stephanie Kuleba, 18, was buried today in Florida. She had it all: popular and pretty, she was captain of the West Boca Raton High School’s varsity cheerleading squad in upscale Boca Raton, FL, drove a white Lexus to school, was an honor student, had received numerous scholarship offers from colleges and was on her way to Florida State University this fall as a pre-med student. She wanted to become a plastic surgeon. So what killed her? Plastic surgery.


While one of her friends described her as “perfect,” Kuleba apparently wanted to be even more perfect. While many of her friends thought she was having her breasts enlarged, Stephanie had asymmetrical breasts, a common condition, and an inverted areola. No medical intervention is necessary for these conditions, yet procedures to correct them are often done for “self-esteem” reasons. She and her mother arrived at Dr. Steven Schuster’s accredited outpatient clinic on Clint Moore Rd. in Boca at 8:00 a.m. last Friday. A little less than two hours into the surgery, something went terribly wrong.

Stephanie’s metabolism increased and her muscles became rigid — the exact opposite of what’s supposed to happen under anesthesia. It’s believed that Kuleba suffered a hyperthermic reaction to inhaled anesthesia. Malignant hyperthermia is a rare genetic condition for which there’s no routine test. As a reaction to some anesthetics, it causes the body temperature to rise to as high as 110 degrees F., as a patient’s heart rate and metabolism increase. Stephanie’s board-certified plastic surgeon and anesthesiologist contacted the Malignant Hyperthermia Association of the United States. Dr. Henry Rosenberg, the association’s president, said that a Mayo Clinic expert tried to walk Schuster and the anesthesiologist through the complication; Stephanie was given dantrolene, the only known antidote for malignant hyperthermia.

She was rushed to the Delray Medical Center in Delray Beach, FL and was treated in the emergency room before being put on life support. Then her kidneys stopped worked and her blood wouldn’t clot. She had a fever of 108 degrees and was bleeding all over. She died at Delray less than 24 hours after the surgery, on Saturday morning. Dr. Tony Dardano, himself a plastic surgeon and chief of staff at Delray, told the Sun-Sentinel: “This is an unfortunate event that can occur to any anesthesiologist, any surgeon and any patient in any operating room at any time without warning…It’s an anesthesiologist’s and a surgeon’s nightmare and it doesn’t matter if it’s a cosmetic procedure or a surgery for reconstruction. That’s what’s so scary about it.”

Because the condition is so rare, statistics about those who develop malignant hyperthermia are hard to find; it’s believed that one in 20,000 to 100,000 patients undergoing anesthesia develop the condition, and one in 10 of those will die. In fact, malignant hyperthermia is so rare that no cases of it are recorded in the American Society of Plastic Surgeons (ASPS) database of 1.4 million plastic surgeries performed in outpatient surgery settings.

Other statistics are more alarming, though. In our relentless pursuit of perfection, breast augmentation surgery has increased nearly 64 percent since 2000, with 348,000 of the procedures performed in 2007. And the American Society for Aesthetic Plastic Surgery says that the number of girls younger than 18 who got breast implants nearly tripled between 2002 and 2003 — from 3,872 to 11,326. And ABC News reports that doctors are seeing “more parents giving their teens the gift of new breasts or other cosmetic surgery for milestones like birthdays or graduations,” even as the ASPS’s position is that no one under the age of 18 should have unnecessary cosmetic surgery. There have also been instances when mothers and daughters go under the knife together, for plastic surgery procedures.

Hundreds mourned Kuleba at the Babione Funeral Home yesterday and at a funeral Mass held at St. Jude Catholic Catholic Church in Boca this morning. Her parents, Joanne Jude Haney Kuleba and Thomas John Kuleba, have declined to comment to the media. According to family attorney Roberto Stanziale, the Kuleba family wants to find out what killed their daughter and if her death could have been prevented. Can you spell lawsuit? What about not letting your daughter, who still lived under your roof, undergo surgery for medical conditions which have no real sequela? The sad part is, Stephanie was already loved for herself, just the way she was, by the hundreds of friends who mourn her death. A poor body image and low self-esteem are what killed Stephanie Kuleba. Her motto on her MySpace page was “live your life.” Unfortunately, Stephanie won’t get to.